Illicit Use of LSD or Psilocybin,but not MDMA or Nonpsychedelic Drugs,is Associated with Mystical Experiences in a Dose-Dependent Manner

Abstract

Psychedelic drugs have long been known to be capable of inducing mystical or transcendental experiences. However, given the common “recreational” nature of much present-day psychedelic use, with typical doses tending to be lower than those commonly taken in the 1960s, the extent to which illicit use of psychedelics today is associated with mystical experiences is not known. Furthermore the mild psychedelic MDMA (“Ecstasy”) is more popular today than “full” psychedelics such as LSD or psilocybin, and the contribution of illicit MDMA use to mystical experiences is not known. The present study recruited 337 adults from the website and newsletter of the Multidisciplinary Association for Psychedelic Studies (MAPS), most of whom reported use of a variety of drugs both licit and illicit including psychedelics. Although only a quarter of the sample reported “spiritual” motives for using psychedelics, use of LSD and psilocybin was significantly positively related to scores on two well-known indices of mystical experiences in a dose-related manner, whereas use of MDMA, cannabis, cocaine, opiates and alcohol was not. Results suggest that even in today's context of “recreational” drug use, psychedelics such as LSD and psilocybin, when taken at higher doses, continue to induce mystical experiences in many users.     

Increased intensity of Ecstasy and polydrug usage in the more experienced recreational Ecstasy/MDMA users: a WWW study

Recreational Ecstasy/MDMA (3,4-methylenedioxymethamphetamine) users often take a variety of psychoactive drugs, but there is little empirical data on how these drug consumption patterns change with greater experience of Ecstasy. The aim of this study was to compare the polydrug usage patterns reported by non-Ecstasy users, novice Ecstasy users, moderate Ecstasy users, and heavy Ecstasy users. In a WWW study of 763 unpaid volunteers, 481 had never taken Ecstasy, whereas 282 reported they had taken it. The Ecstasy users comprised 109 novice users (1-9 occasions), 136 moderate Ecstasy users (10-99 occasions), and 36 heavy Ecstasy users (+100 occasions). Each participant also reported their experience with a range of other psychoactive drugs. The Ecstasy users reported significantly greater psychoactive drug usage than the non-Ecstasy users. The novice, moderate, and heavy Ecstasy users also differed significantly from each other in the use of cocaine, amphetamine, LSD, and psilocybin mushrooms, but not of alcohol, cannabis, or cigarettes/nicotine. Experienced Ecstasy users also took significantly more MDMA tablets on each occasion, and reported a higher maximum weekly intake. The increased use of Ecstasy is associated with more intensive patterns of Ecstasy/MDMA intake, and the greater use of illicit CNS stimulants and hallucinogens, but not of alcohol, nicotine, or cannabis. These results are discussed in the context of cross-tolerance and drug predisposition/preference.     

Popular intoxicants: what lessons can be learned from the last 40 years of alcohol and cannabis regulation?

In this paper we discuss the relative physical, psychological and social harms of the two most frequently used intoxicant drugs in the UK, namely cannabis and alcohol. Over the past 40 years, the use of both drugs has risen significantly with differential consequences. It is argued that increased policing of cannabis use under the current drug classification system will lead to increased criminalization of young people, but is unlikely to significantly reduce the rates of schizophrenia and psychosis. In comparison, increases in alcohol drinking are related to significant increases in liver cirrhosis hospital admissions and mortality, at a time when mortality rates from other major causes are on the decline. A recent expert-led comparison of the health and social harms to the user and to others caused by the most commonly used drugs in the UK showed alcohol to be more than twice as harmful as cannabis to users, and five times as harmful as cannabis to others. The findings underline the need for a coherent, evidence-based drugs policy that enables individuals to make informed decisions about the consequences of their drug use.     

Patterns of simultaneous polysubstance use in drug using university students

Simultaneous polysubstance use (SPU) is a common phenomenon, yet little is known about how various substances are used with one another. In the present study 149 drug-using university students completed structured interviews about their use of various substances. For each substance ever used, participants provided details about the type, order and amount of all substances co-administered during its most recent administration. Alcohol, tobacco and cannabis were frequently co-administered with each other and with all other substances. Chi-squared tests revealed that when alcohol was used in combination with any of cannabis, psilocybin, MDMA, cocaine, amphetamine, methylphenidate (ps < 0.01) or LSD (p < 0.05) its initial use preceded the administration of the other substance. Paired samples t-tests revealed that when alcohol was used with cocaine (p < 0.01) or methylphenidate (p < 0.05) it was ingested in greater quantities than when used in their absence. Patterns of cannabis use were not systematically related to other substances administered. Finally, using one-sample t-tests, tobacco use was demonstrated to be increased relative to 'sober' smoking rates when used with alcohol, cannabis, psilocybin, MDMA, cocaine, amphetamine (ps < 0.001), LSD (p < 0.01) or methylphenidate (p < 0.05). Results suggest that many substances are routinely used in a SPU context and that the pattern in which a substance is used may be related to other substances co-administered.     

Predictors of using social media to purchase drugs in New Zealand: Findings from a large-scale online survey

BackgroundThere are increasing reports of social media being used to buy and sell illegal drugs internationally. Studies of social media drug markets to date have largely involved general explorations of social media drug transactions in select countries. Social media drug markets may operate differently for different drug types and in different country contexts.AimsTo identify predictors of the use of social media to purchase cannabis, methamphetamine, LSD and ecstasy/MDMA in New Zealand using a large-scale online survey sample.MethodsThe annual New Zealand Drug Trends Survey (NZDTS), an online convenience survey promoted via targeted Facebook™ campaign, was completed by 23,500 respondents aged 16+. Logistic regression models were fitted to identify demographic, drug use and drug market predictors of reporting the use of social media to purchase cannabis, methamphetamine, LSD and ecstasy/MDMA.ResultsFifty-one percent of the sample had purchased cannabis, methamphetamine, ecstasy/MDMA or LSD in the past six months, of which 22% had done so via social media (n = 2,650). Cannabis was the drug type most purchased from social media among drug purchasers (24%), followed by ecstasy/MDMA (13%). Sixty percent of social media purchasers had used Facebook™, 48% Snapchat™, and 20% Instagram™. The leading advantages of social media purchasing were “high convenience” (74%), and “fast transaction speed” (43%). Younger age was a significant predictor of social media purchasing for all drug types (particularly among 16–17 year olds). Purchasing from someone identified as a “drug dealer” was a predictor of social media purchasing among respondents for all drug types.ConclusionSocial media drug markets may have significant implications for drug purchasing by youth through providing greater access to supply and breaking down age-related barriers between social supply and commercial drug markets. Our findings highlight the importance of incorporating social media platforms into youth drug prevention and harm minimisation strategies.     

Correspondence between Oral Fluid Drug Test Results and Self-Reported Illicit Drug Use among Music Festival Attendees

Background: Use of illicit substances is often under-reported. Testing positive in oral fluid provides an objective confirmation of recent intake. Objectives: To examine the agreement between oral fluid test results and self-reported substance use among music festival attendees, and factors associated with reporting past 48?h drug use among users identified by drug testing. Methods: One thousand three hundred nine participants were recruited from six music festivals in Norway (June–August 2016). They completed a questionnaire and provided oral fluid samples analyzed for amphetamines, MDMA, tetrahydrocannabinol (cannabis), and cocaine. Additionally, their blood alcohol levels were measured. Results: Overall, 5.5% reported use of amphetamines, cannabis, cocaine, and/or MDMA during past 48?h in the questionnaire, whereas 10.8% tested positive in oral fluid. Only 16.7% of identified cocaine users and 31.1% of identified MDMA users reported past 48?h cocaine or MDMA use, respectively. Higher proportions of identified cannabis and amphetamine users reported past 48?h use (53.8% and 55.6%, respectively). Multivariable logistic regression analysis showed that among participants who tested positive, those reporting weekly illicit substance use (Adjusted Odds Ratio [AOR] 30.6; 95% Confidence Interval [CI] 6.3–147.9), and using such substances when younger than 18?years (AOR 5.0; 95% CI 1.9–13.4) were more likely to report past 48?h use. Conclusions/Importance: Oral fluid testing appears to be an important tool when studying illicit substance use among music festival attendees, as significant under-reporting was observed. Among those testing positive, regular, and experienced users were more likely to report recent use, compared to less regular and experienced users.     

Ecstasy (MDMA) in Recreational Users: Self-Reported Psychological and Physiological Effects

Twenty recreational drug users were asked to describe the psychological and physiological effects they experienced under MDMA (3,4-methylenedioxymethamphetamine). The subjects comprised 11 males and nine females, in the age range 18–31 years. Five subjects had taken MDMA once, nine had taken it 2–9 times, while six subjects had taken it +10 times. Each subject completed a modified Profile of Mood States Questionnaire (POMS), an Ecstasy Effect Questionnaire, and a structured interview, covering past experience with MDMA. Increased feelings of elation, agreeableness, energy, and mental confusion were reported on-drug (p < 0·001), together with faster heart rate, feeling hot, increased sweating and dehydration, dilated pupils, and tight jaw (trismus). Coming off-Ecstasy led to feelings of lethargy, moodiness, insomnia, depression, irritability, and paranoia. Bad MDMA trips were reported by 25 per cent of the sample, following a variety of unpleasant experiences. Chronic pharmacodynamic tolerance was not apparent, since although regular users all described their first MDMA experience as ‘the most intense’, later trips were affected by knowledge and expectancy, rather than any diminution in drug response. Acute pharmacodynamic tolerance was, however, evident, with a period between drugs being described as necessary in order to maintain drug effectiveness. This may help explain the low addiction potential of MDMA. © 1997 John Wiley & Sons, Ltd.     

Virtual raves and happy hours during COVID-19: New drug use contexts for electronic dance music partygoers

BackgroundThe popularity of virtual raves and happy hours has increased during the COVID-19 pandemic. While nightlife settings are often associated with drug use, it is unknown whether virtual events are associated with use.MethodsElectronic dance music (EDM) partygoers who live in New York and reported recent drug use were recruited online and screened for eligibility throughout April and May 2020. Eligible adults (n = 128) were asked about virtual rave and happy hour attendance during the COVID-19 crisis. We examined prevalence and correlates of drug use during such events.Results55.5% of participants attended virtual raves and 69.5% attended virtual happy hours. 40.9% used illegal drugs during virtual raves and the most frequently used drugs were cannabis (29.6%), ecstasy/MDMA/Molly (8.5%), LSD (7.0%), and cocaine (4.2%). 33.7% used illegal drugs during virtual happy hours and the most frequently used drugs were cannabis (29.2%), cocaine (3.4%), and ketamine (3.4%). Older participants were more likely to use illegal drugs during virtual raves, and those reporting past-year use of more drugs were more likely to use drugs during virtual raves and/or happy hours (ps<0.05).ConclusionsEDM partygoers are at risk for using drugs during virtual events. Results can inform prevention and harm reduction efforts.     

The use of multi-national web surveys for comparative analysis: Lessons from the European Web Survey on Drugs

BackgroundMost comparative drug policy analyses utilise measures of drug use, often from general population surveys (GPS). However, the limitations of GPS are well-recognised, including the small numbers of people who use illicit drugs sampled. Web surveys offer a potential solution to such issues. Therefore EMCDDA conducted a study to assess the potential for using such surveys to supplement information obtained from GPS.MethodsThe European Web Survey on Drugs (EWSD) asked about use of cannabis, amphetamines, cocaine and MDMA in 14 countries from 2016 to 2018. Each participant country translated the questionnaire as necessary and devised its own sampling strategy. Individuals aged 18+, resident in the participant country, who had used one or more of the drugs covered by the survey in the past 12 months were included in the analysis. Participation was anonymous and voluntary.ResultsMore than 40,000 people completed the survey, with recruitment mostly through social media. Larger samples of users of all drug types than found in GPS were generally obtained. However, the respondent profiles differed markedly between countries, e.g. the proportion aged 18–24 ranged from 30% to 80%. The results relating to use showed both inter-country similarities and differences, e.g. mean daily amounts of cocaine used varied between countries but increases in amounts used with increased frequency of use were similar. Price data showed good external validity.ConclusionWeb surveys offer the possibility of collecting information from large numbers people who use illicit drugs quickly and cheaply and can fill important gaps in our knowledge of patterns of use, particularly by recreational users. However, they also have limitations. Standardising questionnaires and approaches to data cleaning and analysis facilitates comparisons between countries but obtaining comparable samples may be challenging. Multinational surveys need to balance standardisation of methods with responsiveness to differing country contexts; our collaborative model does this.     

‘I could have went down a different path’: Talking to people who used drugs problematically and service providers about Irish drug policy alternatives

BackgroundPeople who use drugs problematically are consistently left out of consultations and deliberation on drug policy. This article explores how people who formerly used drugs problematically and service providers view Ireland's current drug policy and if alternative policies could be successful in an Irish context.MethodsSemi-structured interviews were conducted with eight people who used drugs problematically and six practitioners working with people who use drugs in Cork city, Ireland. All people who used drugs problematically had at least one year of abstinence and had been criminalised because of their drug use, all but one had served at least one custodial sentence. Participants were asked their opinions on safe injecting facilities, heroin assisted treatment, decriminalisation of drugs for personal use, depenalisation of cannabis and, the relationships between economic deprivation and problematic drug use.ResultsRespondents stressed that, in Cork city, problematic drug use is closely linked with economic deprivation and social exclusion. There was a near consensus that criminalisation and penalisation do not deter consumption and produce unintended consequences. All participants supported safe injecting facilities and the decriminalisation of drugs for personal use. Participants were less certain about the utility of heroin assisted treatment and depenalisation of cannabis. Many discussions drifted away from alternatives policies towards the need for improved treatment provision.ConclusionSeveral participants were clear that none of the alternative policies discussed are silver bullets. Participates felt that, while they could reduce the harms caused by drugs and drug policies, the government's longer-term objectives should be increased treatment provision and, reduced social exclusion and economic deprivation.     

MDMA in humans: factors which affect the neuropsychobiological profiles of recreational ecstasy users, the integrative role of bioenergetic stress

Many recreational ecstasy/MDMA users display neuropsychobiological deficits, whereas others remain problem free. This review will investigate some of the drug and non-drug factors which influence the occurrence of these deficits. Acute and chronic MDMA usage are both important. Intensive use within a session is often associated with more problems. In term of lifetime usage, novice users generally remain unimpaired, whereas most heavy users report memory or other psychobiological problems which they attribute to ecstasy. These complaints are confirmed by objective deficits in working memory, attention, frontal-executive, and episodic memory tasks. Psychobiological deficits include disturbed sleep, sexual dysfunction, reduced immuno-competence, and increased oxidative stress. Further MDMA-related factors which may contribute to these changes, include acute and chronic tolerance, and drug dependence. Around 90?95% of ecstasy/MDMA users also take cannabis, and this can independently contribute to the adverse neuropsychobiological pro.les; although in some situations the acute co-use of these two drugs may be interactive rather than additive, since cannabis has relaxant and hypothermic properties. Alcohol, nicotine, amphetamine, and other drugs, can also affect the psychobiological pro.les of ecstasy polydrug users in complex ways. Pure MDMA users are rare but they have been shown to display significant neurocognitive deficits. Psychiatric aspects are debated in the context of the diathesis-stress model. Here the stressor of ecstasy polydrug drug use, interacts with various predisposition factors (genetic, neurochemical, personality), to determine the psychiatric outcome. Recreational MDMA is typically taken in hot and crowded dances/raves. Prolonged dancing, feeling hot, and raised body temperature, can also be associated with more psychobiological problems. This is consistent with the animal literature, where high ambient temperature and other metabolic stimulants boost the acute effects of MDMA, and cause greater serotonergic neurotoxicity. In conclusion, the neuropsychobiological effects of MDMA are modulated by a wide range of drug and non-drug factors. These multiple influences are integrated within a bioenergetic stress model, where factors which heighten acute metabolic distress lead to more neuropsychobiological problems.     

The relative contributions of ecstasy and cannabis to cognitive impairment

RATIONALE: (+/-)-3,4-methylenedioxymethamphet-amine (MDMA; 'ecstasy'), a commonly used recreational drug, has typically been found to be related to poor cognitive function in humans. However, cannabis consumption may not have been adequately controlled for in these studies. OBJECTIVE: The present study was designed to further elucidate the relation between MDMA and cannabis in cognitive impairment. METHODS: Subjects who had used neither MDMA nor cannabis (controls; n=31), cannabis but not MDMA (cannabis users; n=18) and both MDMA and cannabis (MDMA/cannabis users; n=11) were compared on a battery of neuropsychological tests. RESULTS: The cannabis and MDMA/cannabis groups did not differ on any of the tests, whereas the combined cannabis and MDMA/cannabis groups performed more poorly than controls on tests of memory, learning, word fluency, speed of processing and manual dexterity. Further, apart from speed of processing where higher MDMA consumption predicted slower processing, covariate analysis revealed that the deficits were more closely related to cannabis than MDMA usage. CONCLUSION: The results suggest that cannabis is an important confound in studies of MDMA-related cognitive impairment, and that previously reported cognitive impairment in MDMA users may have been caused by coincident cannabis use.     

Contribution of cannabis and MDMA ("ecstasy") to cognitive changes in long-term polydrug users

Rationale Establishing whether cognitive changes follow long-term use of MDMA ("ecstasy") in humans has been difficult because of possible confounds with other drug use, particularly cannabis. Convincing evidence may be only obtained using experimental designs that account for such confounds.Objective In the present study, cognitive/behavioural measures were used to investigate whether long-term MDMA use or long-term cannabis use is responsible for the changes sometimes observed in recreational MDMA users.Method Tests of attention and memory were administered to subjects who used both MDMA and cannabis, cannabis only, or neither drug.Results The main finding was that cannabis users, whether or not they also used MDMA, showed significantly impaired memory function on word free-recall and on immediate and delayed story recall compared to non-users.Conclusions The findings highlight the importance of controlling for other drug use (particularly cannabis) when investigating persistent effects of MDMA in humans.     

Subgroup trends in alcohol and cannabis co-use and related harms during the rollout of recreational cannabis legalization in Washington state

BackgroundThe US state of Washington legalized recreational cannabis in 2012; how this impacted the co-use of cannabis and alcohol in the population overall and among key subgroups has not been examined. The aim of this study is to investigate changes in patterns of alcohol- and cannabis use and alcohol-related harms during the rollout of retail recreational cannabis stores.MethodsData come from six cross-sectional samples recruited between January 2014-October 2016 via Random Digit Dial procedures (N = 5492). Survey-weighted multivariable regression adjusting for gender, age, race/ethnicity, education, employment, marital status, cannabis use, and survey year were used for statistical analyses.ResultsIn the sample overall, no significant changes were observed in any alcohol use measures between 2014–2016, while the prevalence of cannabis use significantly (P < 0.05) increased from 25.0% to 31.7%, the prevalence of alcohol-related harms at home significantly decreased from 2.1% to 1.0%, and the prevalence of alcohol-related financial harms decreased from 1.5% to 0.8%. Both women and men significantly increased any cannabis use, while women also experienced significantly fewer alcohol-related harms at home and financial harms over time, and increases in the prevalence of cannabis users/non-drinkers. Those 18–29 years old significantly reduced the number of drinking days and overall volume in the past 30 days, and those 30–49 years old significantly decreased alcohol-related harms at home and financial harms. Those 50+ years old significantly increased any cannabis use and simultaneous use of cannabis and alcohol. Non-cannabis users slightly decreased average number of drinks/day, and cannabis users significantly decreased alcohol-related financial harms.ConclusionsBetween 2014–2016, the years during and immediately following the introduction of legal recreational cannabis stores in Washington state, there were no significant changes in cannabis and alcohol co-use or overall alcohol consumption. The only significant changes in the sample overall were an increase in any cannabis use and decreases in alcohol-related harms at home and alcohol-related financial harms.     

An Examination of Beliefs and Opinions about Drug Use in Relation to Personal Stigmatization towards Drug Users

Abstract

Stigma can be harmful to drug users, particularly those in need of treatment. Beliefs and opinions about drug use may influence how individuals view or treat drug users, so research was needed to examine whether specific beliefs and opinions are related to stigma towards users. A sample of 531 adults was assessed to examine how stigmatization relates to specific beliefs and opinions about drug use. Eighty percent of the sample reported lifetime use of an illicit drug. While controlling for demographic characteristics, lifetime drug use and exposure to users, stigmatization towards users more than doubled the odds of reporting that addiction is a choice, and more than tripled the odds for reporting that marijuana and heroin are equally dangerous. Stigmatization, however, lowered the odds of reporting that drugs would be okay to use if legal. Individuals who stigmatize drug users may be under-educated about drug use; however, such individuals appear to be at low risk for use. Beliefs and opinions guided by misinformation may negatively affect users, so public health efforts are needed to educate individuals about drug use and addiction in an objective manner, and treat use as more of a health behavior and less of a moral behavior.     

Results of an international drug testing service for cryptomarket users

IntroductionUser surveys indicate that expectations of higher drug purity are a key reason for cryptomarket use. In 2014–2015, Spain's NGO Energy Control conducted a 1-year pilot project to provide a testing service to cryptomarket drug users using the Transnational European Drug Information (TEDI) guidelines. In this paper, we present content and purity data from the trial.Methods219 samples were analyzed by gas chromatography associated with mass spectrometry (GC/MS). Users were asked to report what substance they allegedly purchased.Results40 different advertised substances were reported, although 77.6% were common recreational drugs (cocaine, MDMA, amphetamines, LSD, ketamine, cannabis). In 200 samples (91.3%), the main result of analysis matched the advertised substance. Where the advertised compound was detected, purity levels (m ± SD) were: cocaine 71.6 ± 19.4%; MDMA (crystal) 88.3 ± 1.4%; MDMA (pills) 133.3 ± 38.4 mg; Amphetamine (speed) 51.3 ± 33.9%; LSD 123.6 ± 40.5 μg; Cannabis resin THC: 16.5 ± 7.5% CBD: 3.4 ± 1.5%; Ketamine 71.3 ± 38.4%. 39.8% of cocaine samples contained the adulterant levamisole (11.6 ± 8%). No adulterants were found in MDMA and LSD samples.DiscussionThe largest collection of test results from drug samples delivered from cryptomarkets are reported in this study. Most substances contained the advertised ingredient and most samples were of high purity. The representativeness of these results is unknown.     

Harm,tangible or feared: Young Victorians’ adverse experiences from others’ drinking or drug use

BackgroundHarms from alcohol experienced by someone other than the drinker have received increasing attention of late, but have not been compared to harms from others’ drug use. The aim of the current study is to compare the reported harms that are attributable to the alcohol use of others to those attributable to drugs, distinguishing between different types of harm in order to highlight how reported harms may be influenced by perception and social standing of use of the substance.MethodRespondents aged 16–24 from Victoria, Australia, completed the Victorian Youth Alcohol and Drug Survey (n = 5001), including questions on demographics, drug and alcohol consumption, on the types of harms they experienced attributable to drugs and alcohol, as well as harms they perpetrated after using drugs or alcohol.ResultsFor both drug and alcohol related harms, reports of harms loaded into two groups using multiple correspondence analysis: tangible harms such as assault, and amenity impacts such as being annoyed by people under the influence. Amenity impacts attributed to alcohol were more likely to be experienced by those who reported drug use and vice versa, while the tangible impacts were more likely to be reported by those who used both drugs and alcohol.ConclusionsReports of amenity impacts from others appear to be influenced by the perception of the drug in question more than tangible impacts such as assault. Particularly for amenity impacts, the greater stigma attached to drug use may make respondents more likely to consider themselves harmed by drugs than they would when compared to alcohol, something that needs to be taken into account when assessing harms by either alcohol or drugs.     

Cannabis-related Experiences and Rate of Cultivation: Would they change under a policy of decriminalization?

It has been argued by many involved in the treatment and prevention of drug-related problems that policies of prohibition have been largely ineffective, that they produce a range of health, social and economic harms, and may well have contributed to an increase in the use of some illicit drugs. Policy makers in some countries are considering the adoption of strategies which aim to reduce harm without necessarily eliminating drug use. One strategy has been to decriminalize some substances. In Australia, two States have decriminalized the use of cannabis, and other states are considering this move. Fifty-five cannabis users contacted through a Western Australian university completed an anonymous questionnaire which (i) explored their experiences as cannabis users under the current policy of prohibition where any use or possession is a criminal offence; and (ii) asked for their predictions about their cannabis-related behaviour under a theoretical system of cannabis policy based on the South Australian Cannabis Expiation Notice (CEN) system. Under a CEN system, personal use, possession and cultivation of cannabis for personal use is not a criminal offence and attracts a fine. Six key areas relating to cultivation of cannabis for personal use and minimizing harm associated with cannabis use were explored. The findings suggest that under a CEN-like system: cannabis users would probably cultivate significantly more of their personal-use cannabis; cannabis users' access to other illicit drugs, and use of other licit and illicit drugs, may be reduced; and use of the oral ingestion method of administration would probably increase. However, results suggest that under a CEN-like system: a black market for cannabis would probably still exist; consumption of cannabis by cannabis users, at least initially, may increase slightly; and the system would discriminate against the poorer segments of the population. This research provides some support for the introduction of an alternative model of cannabis policy to prohibition in States that operate like Western Australia. However, the CEN system is probably not the ideal system from a harm minimization perspective.     

Sources of drug acquisition among females and males in the European Web Survey on Drugs

BackgroundSocial networks determine the availability of drugs, which in turn affects use patterns. Yet, there is some limited evidence that as frequency of drug use increases, people who use drugs increasingly utilize drug dealers. Further, females more often report receiving drugs for free. Studies on these two phenomena are limited by the substances they examine and the countries in which they have been conducted, and they have not been considered together. We examine whether gender differences in sources is moderated by increased frequency of use across four different substances in a web survey of sixteen European countries.MethodsThe European Web Survey on Drugs was collected from 2016–2018 among the national partners of the European Monitoring Centre for Drugs and Drug Addiction. Individuals who use drugs in sixteen European countries completed an online survey. For herbal cannabis, cannabis resin, cocaine, and MDMA, we examine drug acquisition sources by gender and frequency of use. Sources include through dealers and sharing or free, as well as growing and online markets for cannabis. We model each source with logistic regression with chained multiple imputation and a country fixed-effect and clustered standard errors.ResultsAcross all substances, females who use drugs at low frequencies had significantly lower probabilities than males in using dealers; however, females were equally likely to use dealers when use is frequent. The probability of acquiring drugs for free was higher for females except among those who use most frequently, where the difference became non-significant except for herbal cannabis.ConclusionsFemales and males use dealers to acquire illicit drugs at similar rates when use is more frequent. Except for highest frequency use, females are typically more likely than males to acquire drugs for free. Examinations of supply should consider these gendered differences in acquisition.